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Local doc helps out in ‘slow burn catastrophe’

By Will Grandbois
Sopris Sun Staff

Chad Knaus has long dreamed of using his medical training to help the helpless abroad, but it turns out there’s plenty of need right here in the United States.

Between week long shifts in the poorer parts of Colorado through the Docs Who Care program and volunteering with sister program Heart to Heart International in the wake of the 2017 Hurricane season, he’s had a hard look at the resources available — or lack thereof.

“You get outside some pockets, and it’s not a lot different than developing countries,” he observed. “You sort of do everything.”

Knaus’s medical roots go way back in Carbondale. His father is a fixture at Roaring Fork Family Practice; his grandfather was a veterinarian in western Garfield County.

“I think I got an honest view of what family physicians actually do,” he said.

Indeed, his first stop after his residency at St. Mary’s Hospital in Grand Junction was a five year stint working side by side with his dad. In 2015, he decided it was time for a change and took a 10 month sabbatical to Latin America with his family.

“We wanted our kids to see what most of the world lives like,” he said.

There, he got insight into living conditions and health care, worked on his Spanish, and somehow ended up on a Heart to Heart mailing list. He returned to the United States with a new perspective and an even stronger desire to help.

“It changed what I wanted to do in terms of medicine,” he said. “The reverse culture shock is actually harder.”

He applied to help with Ebola treatment in Liberia, but wasn’t chosen to go. So, although the Kansas City based company mostly works abroad — it’s working on a certification for emergency team type 1, which can operate for two weeks self contained — his first chance to pitch in came when Hurricane Harvey hit Houston. By that time, he was already spending a week at a time in Eads or Rangely or another small Colorado town, and was getting used to being a one man medical act.

That, coupled with his Spanish, proved fortuitous. Rather than administering the sort of emergency medicine some might imagine, Knaus’s role was to man a “safety net clinic” to administer to the acute and chronic needs of the community. With infrastructure damage making it difficult to power a nebulizer or refrigerate insulin and many local doctors in the same boat as their patients, the day-to-day kind of medicine is challenging and essential.

“When people are medically fragile and you add no water or electricity or reliable food source, and they’re going to get sick,” Knaus noted. “You take it all for granted, but when it’s gone you really see the effects.”

After Harvey came Irma, and then Maria, and Heart to Heart had its hands full.

“It was just disaster after disaster,” Knaus said. “Some folks were gone from home for several months.”

The team sent to scope out the situation in Puerto Rico had to take a helicopter in from Haiti, while the medical crew and their supplies ended up hitching a ride on a Royal Caribbean cruise ship. Knaus came later, on a private jet supplied by a pharmaceutical partner. Two weeks after the hurricane, the island was still a complete mess.

“It was the first time I’d been to a place that had been completely broken down. People who had been doing this for years had never seen anything like it,” Knaus said. “We never really got the sense that there was anyone in charge. I hate to have to remind people that these are our fellow U.S. citizens that are suffering.”

The locals were doing their best to make it work.

“They are looking out for each other,” Knaus said. “The image of them sitting around waiting for help just isn’t true.”

Still, with hours to wait for a little fuel or water from a spring, the remaining resources were stretched to the breaking point. And some folks who were ostensibly there to help were only making it worse. That’s why Heart to Heart seeks to be self sufficient, with their own supplies, equipment, a limited pharmacy and more. Their logisticians even know to pack adult diapers and other sanitary items others might overlook.

As such, the team was able to set up in places other relief efforts had barely touched — though they saw plenty of helicopters flying over.

“Overwhelmingly, people were just grateful that we showed up,” Knaus said. “It was a huge morale boost.”

Again, while the immediate emergency medicine was over and hospitals were mostly functional, primary care was almost wholly compromised. Knaus characterized it as “catastrophic in a slow burn sense.”

“You have a huge population of people who couldn’t access their physicians,” he said “I think it’s going to get worse in a lot of ways. A lot of folks don’t expect to have power until February or March. What they really need at this point is infrastructure — linesmen and plumbers and tradesmen.”

The biggest presence on that front that Knaus saw was the Army Civilian Corps, which set right to work clearing roads and alleviating hazards.

Meanwhile, sleeping on the floors of churches and clinics with his fellows, Knaus had a strong sense of camaraderie — even though most are retired and he’s one of the few non-retired volunteers still trying to support a family and afford their own health insurance.

“Everyone was there for the same reason,” he said. “I think what we did there was really worthwhile.”

And if there’s a lesson for folks back home, it’s that things can break down quickly and you don’t have to be a prepper to be prepared.

“Having a basic idea of how you’d survive a natural disaster is really helpful,” he said.